Ashland City Fire, Building &
Life Safety Department
101 Court Street
Ashland City TN 37015
Fire & Life Safety: (615) 792-4531 Building Codes (615) 792-6455
SUBDIVISON APPLICATION
APPLICANT NAME:________________________________
ADDRESS:_______________________________________
________________________________________________
TELEPHONE:___________________________________
PROJECT NAME:__________________________________
NUMBER OF LOTS:______________________________
PLANNING COMMISSION FEES:____________________
Minor Subdivision (Four lots or less): $150.00
Plat Amendment: $150.00
Major Subdivision: $250.00
Note: Mylar shall be presented at the time of Final Subdivision Plat Approval and must be signed by
all parties except for Secretary of the Planning Commission.
Having submitted plans for review by the Ashland City Planning Commission, I understand that I am
responsible for all review fees incurred by the Town of Ashland City. In understand that the fee paid at the
time of submittal is not applicable for the fees incurred through review. With my signature, I verify that I fully
understand that I am responsible for said fees, and that I have received a copy of Ordinance #165.
_____________________________ ___________________
Applicant’s Signature Date